{
  "abstract": "Background Adequate bowel preparation is critical for the success and diagnostic yield of a colonoscopy, facilitating the detection and prevention of colorectal cancer. However, the search for better-tolerated and more effective regimens continues. Elobixibat, a novel ileal bile acid transporter (IBAT) inhibitor, offers a promising alternative to traditional adjuncts like bisacodyl.Methods This is a prospective, single-blind, randomized trial conducted from June 1, 2025, to October 30, 2025. Eligible patients were aged >18 years old and were scheduled for elective colonoscopy. A total of 226 eligible patients were enrolled. The patients were randomly assigned to receive either Elobixibat/PEG or Bisacodyl/PEG bowel preparation. Concealment of randomization was retained by personnel who were not involved in the colonoscopy procedure. The gastroenterology faculty members or trainees were blinded to the assigned treatment arm, while the patients and investigators were aware of the treatment allocation. The primary outcome was the quality of bowel preparation, assessed by the colonoscopist utilizing the validated Boston Bowel Preparation Scale (BBPS). Secondary outcomes included patient tolerability, compliance, and the incidence and severity of adverse events associated with each regimen.Results The study enrolled 226 patients (113 per arm). Both the Elobixibat/PEG and Bisacodyl/PEG regimens achieved comparable rates of adequate bowel cleansing (BBPS≥6), successfully meeting the clinical requirements for a successful colonoscopy. While a statistically significant but clinically minimal difference favored the Bisacodyl/PEG group in the right colon ( P=0.044), the most striking finding was the improved patient experience with Elobixibat/PEG. This regimen demonstrated a highly significant and faster time to initial response (median First Defecation Time: 2 hours vs. 4 hours for Bisacodyl/PEG; P<0.001), along with superior patient tolerability. Elobixibat/PEG significantly reduced the incidence of distressing adverse events, including nausea (four times lower; P<0.001), vomiting (P=0.006), severe abdominal pain/cramps (P<0.001), and sleep disturbance (P=0.002).Conclusions The Elobixibat/PEG regimen was found to be non-inferior to the Bisacodyl/PEG regimen in achieving adequate bowel preparation for colonoscopy, with comparable efficacy in BBPS scores. Crucially, Elobixibat, as an adjunct to PEG, is a viable alternative to the current standard of care (Bisacodyl/PEG), offering similar efficacy with better tolerability. These findings support the use of Elobixibat to optimize bowel preparation strategies, ultimately improving patient experience and comfort without compromising colonoscopy quality.",
  "authors": [
    {
      "affiliations": [
        "Manila Doctors Hospital, Philippines"
      ],
      "name": "Romielle Grazel Joi Ramos"
    },
    {
      "affiliations": [
        "Manila Doctors Hospital, Philippines"
      ],
      "name": "Virgilio Bañez"
    }
  ],
  "title": "IDDF2026-ABS-0343 A prospective, randomized, single-center trial: elobixibat/PEG vs. bisacodyl/PEG for bowel preparation",
  "uid": "3542b15b-5938-5219-abcc-d0531675ce60"
}